Personality correlates of adherence with continuous positive airway pressure (CPAP)

Sleep Breath. 2011 Dec;15(4):687-94. doi: 10.1007/s11325-010-0422-8. Epub 2010 Sep 28.


Introduction: Adherence with continuous positive airway pressure (CPAP) for obstructive sleep apnea (OSA) has been problematic. Understanding the factors associated with nonadherence may assist with psychosocial interventions.

Objective: The objective of this study was to examine the relationship between adherence and three measures of personality and coping strategies.

Methods: Ratings on the behavioral inhibition system/behavioral activation system (BIS/BAS) scales, the ways of coping inventory, and a broad personality measure (mini-IPIP) were analyzed with a binary logistic regression among 63 subjects, adult men (31) and women (32), diagnosed with OSA. Data from the CPAP device was obtained following initial 30 days at minimum, with adherence defined as >4 h/night on 70% of nights.

Results: Elevated BIS was the strongest predictor of nonadherence (r = -.452, p < .01), followed by neuroticism. The regression correctly classified 73% of participants as adherent or nonadherent.

Conclusion: Nonadherence is associated with elevated BIS scores and neuroticism, which indicates that personality factors play a role in determining adherence to CPAP. Although more research is needed to draw firm conclusions, the differences noted in BIS may also point toward differences in neurophysiological function. The BIS scale may be a useful tool for predicting nonadherence and assist with the development of intervention strategies that will increase adherence.

MeSH terms

  • Adaptation, Psychological
  • Adult
  • Aged
  • Character*
  • Continuous Positive Airway Pressure / instrumentation
  • Continuous Positive Airway Pressure / psychology*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Motivation
  • Patient Compliance / psychology*
  • Personality Inventory / statistics & numerical data
  • Psychometrics
  • Risk Factors
  • Sleep Apnea, Obstructive / psychology*
  • Sleep Apnea, Obstructive / therapy*